Healthcare Groups Champion Law to Advance Value-Based Care

Key Insights

• The American Medical Association (AMA), American Academy of Family Physicians (AAFP), and 12 other national healthcare organizations sent a letter to Congress in support of the Value in Health Care Act of 2021.
• Signatories praised the bill’s “comprehensive approach that will strengthen our country’s value-based care program and ensure high quality, lower cost care for our nation’s patients.”
• The letter highlighted the “need for program improvements” to help address health inequities.

Value-Based Care at a “Critical Juncture” After COVID-19

In their joint letter, the organizations wrote that “the value-based care movement is at a critical juncture,” echoing Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler.

Signees noted that the COVID-19 pandemic highlighted the need for and potential of value-based care. The groups emphasized how value-based participants “quickly and effectively” deployed “care coordinators, remote monitoring, data analysis and aggregation, and patient tracking” to manage the pandemic.

The Value in Healthcare Act of 2021 aims to revise regulations for the Medicare Shared Savings Program (MSSP) and “other advanced alternative payment arrangements to encourage participation in such program[s].” According to the letter, the Act’s reforms would help:

• Provide appropriate shared savings rates
• Modify risk adjustment methodologies
• Remove barriers to participation
• Ensure fair and accurate benchmarks
• Provide educational and technical support for ACOs

The bill would increase Medicare ACOs’ savings from 40 percent to 50–60 percent. As Rep. Peter Welch said in a press release, “We need to encourage value, not volume of services. ACOs deliver better care for a better price, and we should continue working to make sure that they succeed.”

Addressing Health Inequities Through Value-Based Care

The letter noted that “program improvements” included in the bill, such as “fair and accurate risk adjustment,” could help combat the “disproportionate impact of COVID-19 on the Black, Latino, and other communities.”

The bill addresses these health disparities, mandating that the Government Accountability Office (GAO) submit a report to compare “health outcomes and racial disparities among Medicare beneficiaries” in alternative payment models and fee-for-service arrangements. The report would address outcomes for at least nine measures, including: completion of annual wellness visits, breast cancer screenings, and emergency room visits.

A section-by-section analysis of the bill added that the report aims to help participating providers “focus on population health” and “address health disparities” to “work toward health equity.”

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